Call Us: (928) 282-4679
Give
Adopt
Contact Us
Home
About Us
Careers
Newsletter Signup
Video Tour
Statistics
2023 Impact Report
2022 Impact Report
2021 Impact Report
Give
Care Club x12 – Monthly Giving
Donation Canisters
Facebook Fundraising
Estate Planning and Endowment Fund
General Donations
Hotel Partnerships
Kennel Sponsorship
Kennel Sponsorship Background Options
Thrift Stores
Vehicle Donations
Wishlist
Adopt
Adoptable Dogs
Adoptable Cats
Adoptable Small Animals
Happy Tails
Volunteer
Shelter Services
Lost and Found / Finding Rover
Re-Home Your Pet
Dog Licenses
Resources
News
Events
Wag ‘N Raffle 2024
Kids & Kritters Summer Camp Registration 2024
Thrift Stores
Owner Surrender Form
Home
/
Owner Surrender Form
OWNER SURRENDER INFORMATION
Date of Request
*
MM slash DD slash YYYY
Employee Initials
What kind of animal are you surrendering?
*
DOG
CAT
OTHER
Puppy?
Yes
No
Kitten?
Yes
No
Declawed?
Yes
No
Specify Other Animal Type
STRAY?
YES
NO
FERAL?
YES
NO
COMMUNITY?
YES
NO
Pet’s Name(s)
*
Age(s)
*
Sex
*
Male
Female
If known, list all breeds that apply.
*
Up to date on vaccines w/proof?
*
Yes
No
FIXED?
*
Yes
No
Microchipped?
*
Yes
No
Are vet records available?
*
Yes
No
Is this a bonded pair?
Yes
No
Any known medical conditions ?
Any known behavior conditions ?
Does your pet get along with (check any that apply):
Dogs, Large
Dogs, Small
Cats
Kids
Adults
Why are you re-homing your pet?
*
Have you tried to re-home your pet via Facebook, Craigslist, Flyers, Friends, Family, Co-Workers?
*
Yes
No
Owner Name:
*
Phone:
*
City:
*
Email :
*
Questionnaire Sent?
*
Yes
No
If not a Sedona Resident, have you reached out to your local shelter?
*
Yes
No
Owner Surrender Fee:
$75 per full grown Pet$20 per Kitten or Puppy
Confirm Owner Surrender Fee:
*
Yes
No
Owner's Initials
*
Notes or Additional Information
Date
MM slash DD slash YYYY
Consent
*
I agree to the Humane Society of Sedona Pet Surrender policies.